Monday, June 28, 2010

On the Fourth of July, it is customary to have a fireworks display celebrating our liberty. The United States of America is a country where citizens enjoy freedom of choice. Yes, we all can make our own decisions and then we are rewarded either with a success or not, but it was our decision.

On the sixth of July CMS will be making some decisions, which may not auger well for DME/HME providers (no freedom of choice). There are going to be some explosive fireworks and my fear is that these will not constitute a celebration. Will this allow providers and dealers free choice? Will a citizen be able to obtain their supplies and medications where they wish? The PECOS (provider enrollment, chain and ownership system) database will eliminate from the program referrals from a non-PECOS registered physician.

I must admit that I find this all very confusing. Again I ask: will dealers be able to provide supplies to their clientele that have been correctly ordered by their patient’s physician or will they be denied? Will this happen on July 6 or be postponed until January 3, 2011? In my 60 odd years in this industry I have never seen such confusion of the part of CMS for both providers and patients.

This is a battle we must fight and there is one way to have some measure of success. You can do a great deal locally. Contact your legislators, get your staff involved, get the senior citizens you know to participate (and senior citizens constitute a large voting block). Make phone calls and send e-mails. Do all of this now!

But please be sure you join the national associations and your state DME association. They have the know how. They have the facts and necessary information to bring to Congress. They have people who call on Congress! But they cannot do any of that if they do not have sufficient funds. The big dollar conglomerates have the lobbyists bringing dollars to get their way. You can help guide votes to keep out of Congress those politicians who only worship money and not their constituents.

Lets get some fireworks of our own and become a team to protect our business and our clientele. Do all of this now!If you need any help, I am always available (shelly.prial@att.net or 877-553-5127).

Friday, June 18, 2010

It is always easy to sit back and watch how things seem to work themselves out. But when they do not work out in your favor, you have a tendency to become upset. Lethargy is when you wait for someone else to do things (that you should do). This may be a lack of energy or just plain apathy and you should never allow that to happen. You have a business to protect.

Every HME company is very important. Each has a loyal following of customers and family caregivers, many of whom have become friends, and it is for these that you must participate in all the efforts to change the many new regulations that CMS has or will try to make the law.

When I read the local newspapers, the NY Times and the Wall Street Journal, one thing becomes crystal clear. Too many senior citizens and others do not understand the new health plan. To be sure, I, too, after studying it as much as possible am not aware what it will really accomplish. I am fully cognizant that the competitive bid is neither fair nor even ethical.

As an industry we have to support all efforts to get the proposed legislation (HR 3790) passed. To bring that about you have to rally all your customers, staff and friends to write and call our senators and representatives.

Get everyone involved and shake off the lethargy and start working together. If we do, we can accomplish many things. Share with me any successes you have had.

Wednesday, June 16, 2010

The day of reckoning is upon us. CMS will announce the winners of the competitive bid on June 25. I am so concerned when I see providers of HME products and services being forced to give away their few remaining profits.

What has happened to our industry? I hear a great deal of complaining and companies saying that this is the end of their ability to survive. IT IS NOT!

This has to be seen as a “call to arms!”

During my long career in this industry I have had the pleasure of speaking at many state association meetings. I have spoken at Medtrade and at NCPA meetings and one thing has become very clear to me. For some inexplicable reason, far too many providers have not joined their state association or the national association. I have asked many providers why they haven’t and the answers have made no sense.

I know I have said this many times. You must belong if you wish to survive. It is as simple as that. If 90 percent of HME providers belonged to their state and national associations there would have been sufficient strength and funds to either stop or change what CMS is doing. They know how to do it!

It is not too late. But I ask that you move with as much speed as possible to join both your state DME association and AAHomecare. Do it now! It was never as important as it is today, with the first bid results leaving very few profits and this pending award threatening to do more of the same.

If you need the number to call for your state association or AAHomecare, call me at (877) 553-5127 and I will give it to you.

Sometimes I feel as if I have spent my entire career trying to lobby for the home health care industry. I am sure that some of my efforts have been noted. I made many trips, both with AAHomecare and on my own, to speak (“lobby”) with our elected officials in D.C. I know I made a great number of friends in Congress and I am sure I may have offended a few.

The important thing is that wherever I went, and always with other providers, we were able to speak about their constituents and how they are affected by legislation. Since I never was in a position to offer any funds for their re-election committees, I spoke about the strength of HME providers and pharmacists to influence voters. It is amazing that when you bring up this topic how carefully they will listen to you.

I always made it a point to carry with me copies of letters, in a loose leaf binder, that I asked my customers, family care givers, employees and friends to send. This was always effective and the senator or representative we were visiting usually called in his health legislative assistant to review the binder and listen to us.

There is no perfect way to make these visits, but I recommend that when AAHomecare asks for volunteers to attend a fly-in, please participate. If you are making a pleasure trip to D.C., please set aside some time for brief visits with your elected officials. If they cannot see you ask to speak with their HLA. You can make a difference.

Please share with me any experiences you have had either in D.C. or when seeing your elected officials at their home base. Every HME provider and pharmacist must make their voices heard in order to accomplish a great deal of good!

I just completed a phone call with an old friend from Chicago. He shared with me his recent experience of hiring two new salespeople.

In Chicago, as in almost every city in the United States, college graduates have not been able to find jobs.

This entrepreneur hired two graduates from a local college at an entry-level salary. It took several weeks to train them about what HME providers offer to the community but he had a novel idea. He decided that since he stocked many of the items that a physician, home health agency or a VNA would normally purchase, he could train his new salespeople to become their supplier. He also realized each of these is also a great source for referrals. A double hit!

Then to make it more challenging for his new sale force, he worked out a commission program. The report he gave me was so upbeat that I could not wait to sit down and prepare this blog.

When things are not going as you would like them to, it leaves you with only a few choices. The smart businessperson will investigate what he or she can do to increase sales and profits. Over the years when I visit with friends at the Medtrade shows, I always ask those in various parts of the country about what they do to continue their growth pattern.

Hiring young people just graduating from college is a wonderful idea. They are young and anxious to prove themselves! The success rate they have performed has been phenomenal. I know many HME providers who got their start in just this fashion. So, all I can say is to please take advantage of this as a golden opportunity.

I would love to hear from some of my readers about what they have done. Please take a few moments and send me a message.

Wednesday, June 2, 2010

There is a goal that every entrepreneur must accomplish: obtaining market share. How to determine market share can be confusing. You read in the industry journals that potential for one of the disciplines you offer can be many million or more dollars. That is usually accurate, but can you utilize that number in your market place?

All of the segments of DME/HME are reported, with some extra emphasis on glucose monitoring and home tele-health. How can you use these reports to your advantage? With very few exceptions in a local market they will not offer much to assist you in obtaining market share. All they will do for you is encourage you to go for it!

It is up to you to develop market share. There are many steps that can be done to help you attain your goal. It is imperative to know the demographics of your community. Armed with this you can start developing promotions. The age groups are one key, but further inquiries must be made. Ihave found that the local Chamber of Commerce will be of great help to show where people reside.

Meet with the VNA and home health associations who service your market. These visits also will open doors to them becoming customers for their supplies (a small bonus). Visit the local hospitals, speak with the supervising nurse, the outpatient and discharge nurses and if possible the administrator. They can become friends and also may be competitors (some have their own DME/HME location).

Somehow DME/HME providers have lost track of the value of time. When Iget calls from dealers often Ihear the same complaint, “there aren‘t enough hours in a day.”

My response is always the same. “You do not schedule your daily activities!” Then I am asked, “How can we do that in an active retail operation?” The solution is in the question! “An active retail operation.” This would never be without a staff.

Iusually use the term “entrepreneur”, but now Iwill us the term “proprietor.” The proprietor will try to do everything by himself and so neglect to correctly utilize his staff. When there are employees to do it then he should not be at the counter waiting on retail trade. He really should be in his office mapping out new strategies. Time must be set aside for that purpose. Should he be running to the warehouse to check on outgoing orders or incoming merchandise when he pays staff to do it? Who should be reviewing invoices and purchase orders to ensure these are correct? Should he be writing purchase orders when there is a purchasing agent? The proprietor cannot do everything! Time management means delegating.

A true entrepreneur would set aside time to monitor all operational activities. (Webster: an entrepreneur is a person who manages a business undertaking, assuming the risk for the sake of profit.)

It is not difficult to sit down and plan daily activities. As the entrepreneur, you know what must be accomplished and by managing the time spent in the office, as well as when out, you will discover very quickly that there is time to achieve all of your goals. Time management is another key to success!

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Shelly Prial

I began my career in 1950 when I graduated from Brooklyn College of Pharmacy. I spent 16 years in retail pharmacy and owned and operated four different pharmacies during this period. It was in the early 1950s that I became interested in durable medical equipment and oxygen services. My pharmacy was one of the first to offer DME and oxygen supplies.
I worked for various companies in the industry and after a few years, I became a manufacturer’s rep. It was there, working with many dealers that the idea of developing a co-op for DME providers developed. My wife and I started the Homecare Providers Co-op (HPC) in 1986 and that proved to be the most exciting period of my career.
After I “retired” some years ago, I found it necessary to stay active. I am proud that I worked for Graham-Field Health Products as their Director of Government Relations.
As a consultant and Medtrade Ambassador, my goal now is to see if I can bring our industry together to work as a team and become formidable.
I am proud to say that I have been married to Thelma since 1950. We have two children and four grandchildren. And, a fun fact? I have attended every Medtrade show since it began in 1979!